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Core Exercises
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Core Exercises - July 17, 2005 1:39:00 PM
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anoopbal
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What are the core exercises you reccomend for improving core strength or functional core strength?
I do sets of flexion, rotation, extension and a stabilty exercises. Is there any exercise reccommended or contraindicated in special cases?
Thanks
Anoop
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Re: Core Exercises - July 22, 2005 6:20:00 AM
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JLS_PT_OCS
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From: USA
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Man, another huge question. You've gotta break these down a bit, buddy.
I think Gray Cook has an interesting perspective on core strength (involving spine movement) and core stability (involving spine stability while other parts are moving).
Most of my patients get Stability exercises before Strength exercises.
I have found the Side Bridge/Lateral Lean exercise useful because of the low shear forces on the spine.
I like modifications of Shirley Sahrmann's curl up and flexion exercises also.
I think Stuart McGill has some sensible recommendations. I do think he makes too many assumptions in leaping from cadaveric models and virtual models to actual people, but I think most of his thoughts resonate pretty well. I am enjoying his perspective in his book Low Back Disorders: Evidence Based Treatment and Prevention.
Certainly anyone with a history of back pain must be questioned closely when prescribing exercise and communication with their previous Physical Therapist or other health care provider would be necessary.
J
_____________________________
Jason Silvernail DPT, OCS, CSCS
"It isn't what you're able to do that requires your courage but rather what you have come to understand and are willing to express." - Barrett Dorko,PT
**I no longer post on RehabEdge**
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Re: Core Exercises - July 22, 2005 8:55:00 AM
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anoopbal
Posts: 124
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Thanks Jason.
I have raed Stuart Mcgills book. I asked this in another thread but you might have missed it. So is bracing the way to go or abdominal drawing in?
Someone in the otherthrread made a good pint about bracing to be more in terms of a mechanical models and hollowing more of a motor control rpoblem. I am a bit confused which one I should opt.
And what are Sahrmanns modification exercises for abdomen?
Anoop
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Re: Core Exercises - July 25, 2005 7:02:00 AM
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JLS_PT_OCS
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Ah, the bracing vs hollowing argument.
I think your explanation touches on some of that, though in reading McGill's book, I don't believe his descriptions of the hollowing manuever really describe what that looks like in the clinic. I won't challenge his biomechanical conclusions, but the question remains...what does that have to do with relieving pain?
If curious, get Sahrmann's book. Interesting reading.
J
_____________________________
Jason Silvernail DPT, OCS, CSCS
"It isn't what you're able to do that requires your courage but rather what you have come to understand and are willing to express." - Barrett Dorko,PT
**I no longer post on RehabEdge**
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Re: Core Exercises - June 7, 2006 2:06:00 PM
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GUESTPROUSER
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Russians Twists
Dragon flags
Leg Raises, bent or legs straight
Wieghted decline crunches
Saxon side bends
Seated Leg Raises
And one of the ulimate
Lying tiger bend or ab bridge.
http://www.coachkengrace.com/FrontBridge.jpg
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Re: Core Exercises - June 7, 2006 2:30:00 PM
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GUESTPROUSER
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Joined: June 6, 2006
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Increase time on tiger bend
Sets
eg: 4 sets of 1min = 4mins
1min, 1min, 1min, 1min
1min ab stretch between each
then
next time
1min 30 secs, 30secs, 1min, 1min
the goal here is to get you to hold your ab for a full 4mins, and basically to get you use to yours abs holding your bridge.
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Re: Core Exercises - June 7, 2006 2:33:00 PM
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jma
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From: NY
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Also known as the Plank Exercise.
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Re: Core Exercises - June 7, 2006 5:31:00 PM
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ysumpt2006
Posts: 113
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From: Youngstown, Ohio
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PT Journal March of 2005. Koumantakis et al found that general trunk exercises were "better" (via outcomes) than traditional stability exercises (core stuff) in patients with LBP.
Heck, I just finished a case report and ready to put it into an RTC using eccentrics to aid in LBP
_____________________________
Ken Shearer, PT
Certified Strength and Conditioning Specialist
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Re: Core Exercises - June 8, 2006 1:55:00 AM
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rwillcott
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From: Canada
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ysumpt2006,
I would be careful when interpreting the Koumantakis study. You are right when you say that this study found no difference between general trunk exercises and specific stability exercisies. In fact the general trunk exercise group did better on disability scores in the short term.
However, all patients presenting with clinical signs suggesting spinal instability were excluded from the study! Thats correct! They excluded the very group of patients that would benefit from these exercises ( abberant movement, catching pain, thigh climbing, spondylolisthesis, positive prone stability test etc.)
As a colleague explained to me once, it's equivalent to performing a study on the effectiveness of appendectomies. However, prior to beginning the study you exclude all patients with cardinal signs and symptoms of appendicits. Then make the conclusion that appendectomies are not effective for the treatment of abdominal pain.
The treatment of back pain is no different. Back pain is caused by many factors. This is where the use of clinical practice guidleines is useful.
This study is an example of being careful what the results are telling us. One positive aspect of this study is that it tells us that if a patient does not meet the clinical prediction rules for spinal stability exercies then they propably won't benefit from these exercises. However, if you were to select the appropriate patients you will notice that they will benefit from specific stability exercises.
Rob
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Re: Core Exercises - September 21, 2006 7:11:00 PM
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kenstack
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From: Raleigh,NC
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the side trunk holds proposed by McGill are difficult with a tendency to fatigue other areas such as the shoulder area. I realize they are supported by some EMG studies but I would prefer some other research based options for that plane of motion.
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Ken Stack, MS,PT,CSCS
Raleigh,NC
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